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Published on: August 13, 2015
Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with stable coronary artery
M I Furman1, S E Benoit, M R Barnard
1Cardiovascular Thrombosis Research Center, Department of Medicine, University of Massachusetts Medical Center, Worcester 01655, USA. mark.furman@banyan.ummed.edu
Insights
Patients with stable coronary artery disease (CAD) exhibit heightened platelet reactivity and form more monocyte-platelet aggregates. These findings suggest increased thrombotic potential in individuals with stable CAD.
Area of Science:
- Cardiovascular Biology
- Hematology
- Immunology
Background:
- Atherosclerosis involves platelet-dependent thrombosis and leukocyte infiltration.
- Understanding cellular events in atherosclerosis is crucial for disease management.
Purpose of the Study:
- To investigate if patients with stable coronary artery disease (CAD) show increased platelet reactivity.
- To determine if stable CAD patients have a greater tendency to form monocyte-platelet aggregates.
Main Methods:
- Whole blood flow cytometry was used to analyze blood samples.
- Blood was collected from 19 patients with stable CAD and 19 healthy controls.
- Samples were incubated with or without platelet agonists to assess reactivity.
Main Results:
- Patients with stable CAD had significantly higher levels of circulating degranulated platelets compared to controls.
- Platelet reactivity to adenosine diphosphate (ADP), ADP/epinephrine, and TRAP was significantly increased in CAD patients.
- Stable CAD patients demonstrated a higher prevalence of circulating monocyte-platelet aggregates and an enhanced propensity to form them upon stimulation.
Conclusions:
- Patients with stable coronary artery disease possess circulating activated platelets.
- Increased platelet reactivity and monocyte-platelet aggregate formation are characteristic of stable CAD.
- These findings highlight the role of platelet activation and aggregation in the pathophysiology of stable CAD.
Objectives:
We sought to examine whether patients with stable coronary artery disease (CAD) have increased platelet reactivity and an enhanced propensity to form monocyte-platelet aggregates.
Background:
Platelet-dependent thrombosis and leukocyte infiltration into the vessel wall are characteristic cellular events seen in atherosclerosis.
Methods:
Anticoagulated peripheral venous blood from 19 patients with stable CAD and 19 normal control subjects was incubated with or without various platelet agonists and analyzed by whole blood flow cytometry.
Results:
Circulating degranulated platelets were increased in patients with CAD compared with control subjects (mean [+/- SEM] percent P-selectin-positive platelets: 2.1 +/- 0.2 vs. 1.5 +/- 0.2, p < 0.01) and were more reactive to stimulation with 1 micromol/liter of adenosine diphosphate (ADP) (28.7 +/- 3.9 vs. 16.1 +/- 2.2, p < 0.01), 1 micromol/liter of ADP/epinephrine (51.4 +/- 4.6 vs. 37.5 +/- 3.8, p < 0.05) or 5 micromol/liter of thrombin receptor agonist peptide (TRAP) (65.7 +/- 6.8 vs. 20.2 +/- 5.1, p < 0.01). Patients with stable CAD also had increased circulating monocyte-platelet aggregates compared with control subjects (percent platelet-positive monocytes: 15.3 +/- 3.0 vs. 6.3 +/- 0.9, p < 0.01). Furthermore, patients with stable CAD formed more monocyte-platelet aggregates than did control subjects when their whole blood was stimulated with 1 micromol/liter of ADP (50.4 +/- 4.5 vs. 28.1 +/- 5.3, p < 0.01), 1 micromol/liter of ADP/epinephrine (60.7 +/- 4.3 vs. 48.0 +/- 4.8, p < 0.05) or 5 micromol/liter of TRAP (67.6 +/- 5.7 vs. 34.3 +/- 7.0, p < 0.01).
Conclusions:
Patients with stable CAD have circulating activated platelets, circulating monocyte-platelet aggregates, increased platelet reactivity and an increased propensity to form monocyte-platelet aggregates.
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